Occurrence of antibodies to Anaplasma phagocytophilum in patients with suspected tick-borne encephalitis
More details
Hide details
Faculty of Medicine, Department of Epidemiology, P. J. Šafárik University, Košice, Slovak Republic
Ann Agric Environ Med 2015;22(3):409–411
Introduction and objectives:
Human granulocytic anaplasmosis (HGA) is an emerging tick-borne infectious disease caused by Anaplasma phagocytophilum. In Europe, the first serological evidence of HGA was described in 1995 in Switzerland, and the first clinical case was confirmed in 1997 in Slovenia. Since then, many European countries, including Slovakia, have reported the occurrence of HGA. The aim of this study was to examine the occurrence of IgG antibodies against A. phagocytophilum in blood sera of humans with suspected tick-borne encephalitis.

Material and Methods:
181 people were examined for the presence of anti-A. phagocytophilum IgG antibodies; 113 were patients with suspected TBE (65 males, 48 females), and 68 from the control group (18 males, 50 females). Respondents were aged 2–80 years (mean age: 31.39; STD: 17.1). Anti-A. phagocytophilum IgG antibodies were detected by the IFA IgG test. Relative risk (RR) and their 95% confidence intervals (95% CI) were estimated for the occurrence of IgG A. phagocytophilum antibodies.

Of the total number of 181 people examined, 32 (17.7%) showed positive for IgG antibodies against A. phagocytophilum, 22 of whom were patients with suspected TBE (19.5%) and 10 people from control group (14.7%). The RR of occurrence of IgG A. phagocytophilum was 1.3-times higher in the patients with suspected TBE than in the control group.

None of the examined patients with suspected TBE had the disease confirmed. Hoever, as shown by the results, the relative risk of occurrence of anaplasmosis is higher in people examined for some another vector-borne disease (in this case TBE). Therefore, the performance of screening examinations in patients suspected of having any tick-borne disease is very important.

1. Chen S, Dumler JS, Bakken JS, Walker AR. Identification of a granulocytotropic Ehrlichia species as the etiological agent of human disease. J Clin Microbiol. 1994; 32: 589–595.
2. Dumler JS, Barbet AF, Bekker CPJ, Dasch GA, Palmer GH, Ray SC, Rikihisa Y, Rurangirwa FR. Reorganization of genera in the families Rickettsiaceae and Anaplasmataceae in order Rickettsiales: unification of some species of Ehrlichia with Anaplasma, Cowdria with Ehrlichia and Ehrlichia with Neorickettsia, descriptions of six new species combinations and designation of Ehrlichia equi and “HGE agent” as subjective synonyms of Ehrlichia phagocytophila. Int J Syst Evol Microbiol. 2001; 51: 2145–2165.
3. Brouqui P, Dumler JS, Lienhard R, Brossard M, Raoult D. Human granulocytic ehrlichiosis in Europe. Lancet 1995; 346: 782–783.
4. Petrovec M, Lotrič-Furlan S, Zupanc TA, Strle F, Brouqui P, Roux V, Dumler JS. Human disease in Europe caused by a granulocytic Ehrlichia species. J. Clin. Microbiol. 1997; 35: 1556–1559.
5. Blanco JR, Oteo JA. Human granulocytic ehrlichiosis in Europe. Clin Microbiol Infect. 2002; 8: 763–772.
6. Hulinska D, Votypka J, Plch J, Vlcek E, Valesova M, Bojar M, Hulinsky V, Smetana K. Molecular and microscopical evidence of Ehrlichia spp. and Borrelia burgdorferi sensu lato in patients, animals and ticks in the Czech Republic. New Microbiol. 2002; 25: 437–448.
7. Santino I, Cammarata E, Franco S, Galdiero F, Oliva B, Sessa R, Cipriani P, Tempera G, Del Piano M. Multicentric study of seroprevalence of Borrelia burgdorferi and Anaplasma phagocytophilum in high-risk groups in regions of central and southern Italy. Int J Immunopathol Pharmacol. 2004; 17: 219–223.
8. Grzeszczuk A. Anaplasma phagocytophilum in Ixodes ricinus ticks and human granulocytic anaplasmosis seroprevalence among forestry rangers in Białystok region. Adv Med Scienc. 2006; 51: 283–286.
9. Edouard S, Koebel Ch, Goehringer F, Socolovschi C, Jaulhac B, Raoult D, Brouqui Ph. Emergence of human granulocytic anaplasmosis in France. Ticks Tick-borne Dis. 2012; 3: 402–404.
10. Chmielewska-Badora J, Zwoliński J, Cisak E, Wójcik-Fatla A, Buczek A, Dutkiewicz J. Prevalence of Anaplasma phagocytophilum in Ixodes ricinus ticks determined by polymerase chain reaction with two pairs of primers detecting 16S rRNA and ankA genes. Ann Agric Environ Med. 2007; 14: 281–285.
11. Wójcik-Fatla A, Szymańska J, Wdowiak L, Buczek A, Dutkiewicz J. Coincidence of three pathogens (Borrelia burgdorferi sensu lato, Anaplasma phagocytophilum and Babesia microti) in Ixodes ricinus ticks in the Lublin macroregion. Ann Agric Environ Med. 2009; 16: 151–158.
12. Nováková M, Víchová B, Majláthová V, Lesňáková A, Pochybová M, Peťko B. First case of human granulocytic anaplasmosis from Slovakia. Ann Agric Environ Med. 2010; 17: 129–133.
13. Carlyon JA, Fikrig E. Invasion and survival strategies of Anaplasma phagocytophilum. Cell Microbiol. 2003; 5: 743–754.
14. Dumler JS, Madigan JE, Pusterla N, Bakken JS. Ehrlichioses in humans: epidemiology, clinic presentation, diagnosis, and treatment. Clin. Infect. Dis. 2007; 45: suppl 1, 45–51.
15. Kmety E, Rehacek J, Vyrostekova V, Gurycova D. Infestation of ticks with Borrelia burgdorferi and Francisella tularensis in Slovakia. Bratisl Lek Listy. 1990; 91: 251–256.
16. Kožuch O, Labuda M, Lysy J, Weismann P, Krippel E. Longitudinal study of natural foci of Central European encephalitis virus in West Slovakia. Acta Virol. 1990; 34: 537–544.
17. Second Expert consultation on tick-borne diseases with emphasis on lyme borreliosis and tick-borne encephalitis. Meeting Report. ECDC, Stockholm, 2012. p.10.
18. Kollaritsch H, Chmelík V, Dontsenko I, Grzeszczuk A, Kondrusik M, Usonis V, Lakos A. The current perspective on tick-borne encephalitis awareness and prevention in six Central and Eastern European countries: report from a meeting of experts convened to discuss TBE in their region. Vaccine 2011; 29: 4556–4564.
19. Gritsun TS, Nuttall PA, Gould EA. Tick-borne flaviviruses. Adv Virus Res. 2003; 61: 317–371.
20. Suss J. Tick-borne encephalitis 2010: Epidemiology, risk areas, and virus strains in Europe and Asia-an overview. Ticks Tick-borne Dis. 2011; 2: 2–15.
21. Strle F. Human granulocytic ehrlichiosis in Europe. Int. J. Med. Microbiol. 2004; 293(Suppl 37): 27–35.
22. Kocianová E, Košťanová Z, Štefanidesová K, Špitalská E, Boldiš V, Hučková D, Stanek G. Serologic evidence of Anaplasma phagocytophilum infections in patients with a history of tick bite in central Slovakia. Wien Klin Wochenschr. 2008; 120: 427–431.
23. Kalinová Z, Halánová M, Čisláková L, Sulinová Z, Jarčuška P. Occurrence of IgG antibodies to Anaplasma phagocytophilum in humans suspected of Lyme borreliosis in eastern Slovakia. Ann Agric Environ Med. 2009; 16: 285–288.